On the pulse

At the RCN Congress in Liverpool this week, some of the most pressing issues facing the nursing profession were on the agenda. In particular, two stories covered by Nursing Times highlighted the need for greater awareness of the value of some nursing roles.

Ebola virus threat to the UK is 'very low'

Health news has been dominated in recent days by the outbreak of the Ebola virus in West Africa, with more than 1,500 confirmed cases and 887 deaths.

Health news has been dominated in recent days by the outbreak of the Ebola virus in West Africa, with more than 1,500 confirmed cases and 887 deaths.Cases have been confirmed in Sierra Leone, Liberia, Guinea and Nigeria. The World Health Organization estimates the current outbreak has a mortality rate of 56%.It is important to note there is currently no direct threat to people in the UK from the Ebola virus.Outbreaks of Ebola are nothing new, but health professionals are concerned about the size of the outbreak.The majority of cases are confined to rural areas, but there has been a reported case of a man infected with the virus arriving via plane in the Nigerian city of Lagos. The man later died.

What is Ebola?

Ebola is a virus that can be spread through blood and bodily fluids. The virus originated in the West African rainforest and is thought to have spread to humans by handling or butchering infected animals.

Once the virus enters the body it can replicate very quickly, causing a range of increasingly harmful symptoms, including internal bleeding. Left untreated it can have a mortality rate as high as 90%.

What are the symptoms of Ebola virus?

An infected person will typically develop a fever, headache, joint and muscle pain, sore throat, and intense muscle weakness. These symptoms start suddenly 2 to 21 days after becoming infected.

Diarrhoea, vomiting, a rash, stomach pain and impaired kidney and liver function follow. The infected person may then bleed internally, as well as from the ears, eyes and mouth.

How is the Ebola virus spread?

People can become infected with the Ebola virus if they come into contact with the blood, body secretions or organs of an infected person.

Some traditional African burial rituals may have played a part in its spread. The Ebola virus can survive for several days outside the body, including on the skin of an infected person.

In parts of Africa it is common for mourners to touch the skin of the deceased. A person then only needs to touch their mouth to become infected.

Other ways people can catch the virus include:

touching the soiled clothing of an infected person and then touching their mouth

having sex with an infected person without using a condom (the virus can be present in semen for as much as seven weeks after an infected person has recovered)

handling unsterilised needles or medical equipment that have been used on the infected person

handling infected animals or coming into contact with their body fluids

A person is infectious as long as their blood and secretions contain the virus.

Ebola virus is generally not spread through routine social contact such as shaking hands with patients without symptoms.

The virus is not airborne, so it’s not as infectious as diseases such as the flu - you’d need to get close to it to catch it.

Who’s at risk from Ebola?

Anyone who has close contact with an infected person or handles samples from patients is at risk of becoming infected. Hospital workers, laboratory workers and family members are at greatest risk.

How is Ebola diagnosed?

It’s difficult to know if a patient is infected with Ebola virus in the early stages. The early symptoms of Ebola, such as fever, headache and muscle pain, are similar to those of many other diseases.

But health workers are on standby to act quickly. If anyone in the UK develops the above symptoms and has potentially been in close contact with the virus, they will be admitted to hospital and will most likely be quarantined.

Samples of blood or body fluid can be sent to a laboratory to be tested for the presence of Ebola virus, and a diagnosis can be made rapidly. If the result is negative, doctors will test for other diseases, such as malaria, typhoid fever and cholera.

What are the treatments for Ebola?

There’s currently no specific treatment or cure for the Ebola virus, although potential new vaccines and drug therapies are being developed and tested.

Patients need to be treated in isolation in intensive care. Dehydration is common, so fluids may be given intravenously (directly into a vein). Blood oxygen levels and blood pressure will be maintained at the correct level, and the body organs supported while the patient recovers.

What is the risk of Ebola in the UK?

The risk to the UK is thought to be very low and there have been no reported cases.

While it is theoretically possible someone with the virus could arrive in the UK, health professionals have been told to watch out for any patient presenting with unusual symptoms.

If this happened, the infected person would then be quickly admitted to hospital and quarantined, as was the case with a man who arrived in the UK and then developed Middle East Respiratory Syndrome in 2012.

Ebola virus is not airborne, so there is no credible risk of a swine flu-like global pandemic.

You cannot catch Ebola by travelling on a plane with someone who is infected, unless you come into very close physical contact with them, such as kissing.

What precautions are being taken?

Public Health England (PHE), the body responsible for public health in England, has told health professionals about the situation in West Africa and asked for vigilance about unexplained illness in people who have visited the affected area.

PHE has provided advice for humanitarian workers planning to work in affected areas. It is also working with people from Sierra Leone living in England.

Advice has already been issued to immigration removal centres on carrying out health assessments for people who may have been in Ebola outbreak areas within the preceding 21 days.

And PHE is liaising with the UK Border Agency and port health authorities to update guidance for staff working in airports and ports.

Dr Brian McCloskey, PHE’s director of global health said: “The risk to UK travellers and people working in these countries of contracting Ebola is very low.

“People who have returned from affected areas who have a sudden onset of symptoms such as fever, headache, sore throat and general malaise [sense of feeling unwell] within three weeks of their return should immediately seek medical assistance.”

Two midwives who travelled to Africa to teach medical staff new skills have described their trip as a “privilege”, after they witnessed the “challenging circumstances” and “limited resources” that staff in Liberia are faced with.

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